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General NPI Number Information
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NPI Number | 1538321542
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Entity Type | Individual
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Provider Name | SHANA ROSE COPLOWITZ MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15 LAUREL AVE STE 100
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City | CORNWALL
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State | NY
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Zip | 12518-1403
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Country | US
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Telephone | 845-458-9000
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Fax | 845-458-9001
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Provider Business Mailing Address
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Address Line | 15 LAUREL AVE STE 100
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City | CORNWALL
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State | NY
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Zip | 12518-1403
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Country | US
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Telephone | 845-458-9000
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Fax | 845-458-9001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 2015003026
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 269932
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License Number State | NY
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